| Objective：Radiotherapy is the most important means with the least complications andthe best treatment effect for patients who suffer from locally advanced malignanttumor but are not suitable to get surgery, can effectively cure a variety of malignanttumors or initiate conservative treatment on the patients in order to improve theirquality of life, but it inevitably cause damage to or have some impact on normaltissue around the radiation field in a certain amount in the process of the treatment.During the radiotherapy of lung cancer, all or part of esophagealareare inevitably exposed in the radiation field of external irradiation, and theesophageal mucosa are especially sensitive to radiation,When the radioactivematerial in the the radiation field has an influence on normal esophageal mucosa,itcancause esophageal nerve muscle injury, hyperemia, edema, swallowing difficulties,which is so-called theradioactive esophagitis.,it is a kind of esophagus injury causedby radiation. Theradioactive esophagitis set the patients into great pain when theyreceive treatment, sometimes even will reduce the theircompliance. Atpresent,domestic treament for radioactive esophagitis most claims given a dose ofantibiotics, hormone drugs such as symptomatic treatment, preventive use ofantibiotics for acute radiation esophagitis, without exact clinical practice guidelines,generally belongs to the experience administration, strictly speaking, belongs to theirrational use of antibiotics as prescribed by the state.Hormone therapy have sideeffects.Kangfuxin liquid can promote the proliferation of mucosa capillaries, granulationtissue hyperplasia and the growth of table cell, rapidly repair damaged skin mucousmembrane, with characteristic of such as safety convenience, less complications andside effects. Pantoprazole electivity is the third generation of proton pump inhibitors,which has a function of repairing injury after the oral absorption of esophageal mucosa, and is mainly used in the treatment of diseases of the digestive system.Atpresent there is no report on the clinical application of the two kinds of the drugs intreatment of acute radiation esophagitis, therefore, based on the combined use ofprevention and treatment of the acute radiation esophagitis clinical curative effectobservation, we expect that this study can find a new efficient way to prevent thehappening of the radioactive esophagitis from the perspective the combination ofChinese and western medicine.Methods：All cases in this research were hospitalized patients with lung cancer selectedfrom siping center radiation hospital between January2013and June2014who wereconfirmed by pathological diagnosis at ages34-78,73cases from the142caseswere male,the other69cases are female.According to the inclusion criteria,the aforementioned142cases wereselected.The patients can be divided into four groups:GroupA: patients injected withKangfuxin Liquid; group B patients injected with pantoprazole; group C:patientsinjectedwith Kangfuxin Liquidand pantoprazole; groupD: control group.All thepatients were informed and consent to the investigation.Drug delivery methods: Group A: Kangfuxin liquid:10ml/time,keep in mouthand swallow slowly.3times A day; Group B: Pantoprazole capsule:40mg/time, oncedaily, on an empty stomach. Group C: rehabilitation Kangfuxin liquid+Pantoprazole,the same usage, dosage, as groupA and groupB.There should be aninterval no less than30minutes between taking the two medicines.Group D: thecontrol group. A, B, C three groups of patients were at the beginning of the radiationmedicine By the end of the radiotherapy the patients in A, B, C three groupswere taking medicine totally for six weeks from the beginning of the radiation..Irradiation method:All into the group of patients to accept three dimensionalconformal radiation therapy, the conventional segmentation way,1.8-2.0Gy/times,1times/day,5times per week, total dose54to60Gy.Observation indexes: radioactive esophagitis occurrence time, radioactiveesophageal inflammation shape (dysphagia, swallow the pain) duration, the incidenceof radiation esophagitis, the severity of the radioactive esophagitis, radioactiveesophagitis, esophageal illuminated dose and radiation completion. By SPSS17.0statistical software for data analysis, normal measurement datausing t test and variance analysis, the measurement data of non-normal distribution ofrank and inspection, rate compared with χ2test, P <0.05, think the difference wasstatistically significant.Results：Four groups in gender, age, course of the disease, patients with esophagealilluminated dose, length of beam in esophageal, clinical stage, pathological type, KPSscore, by the statistical test, there was no statistically significant difference (P>0.05),between groups of comparable. Compared with A group, B group and D group, Cgroup using Kangfuxin Liquid Combined with proton pump inhibitor pantoprazolefirst appeared radioactive esophagitis symptoms was prolonged, with significantdifference (P<0.0001);The duration of the clinical symptoms of C ggroup wassignificantly shorter, the difference was statistically significant (P<0.0001);Radiationesophagitis severity of C group was significantly lower than the A group, B group andD group, with significant difference (P<0.0001);Group C radiation esophagitis wassignificantly decreased, compared with the D group, the difference was statisticallysignificant (P<0.0011);The C group was significantly increased radioactiveesophagitis esophageal dose (P<0.0001), compared with A group, B group and Dgroup, the difference was statistically significant.Conclusion：Kangfuxin Liquid combined with proton pump inhibitor pantoprazole, time ofoccurrence can significantly postpone the time of radiation-induced esophagitisand shorten the duration that the symptoms of radiation esophagitis lasted.Kangfuxin Liquid combined with proton pump inhibitor pantoprazole, cansignificantly reduce the risk and the severity of radiation esophagitis.Kangfuxin Liquid combined with proton pump inhibitor pantoprazole canincrease the dose of radioactive esophagitis.The combined utilization of the two kinds of drugs produces a better curative effect than using one kind singly. |
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